DOI: 10.1177/07067437261462698 ISSN: 0706-7437

Prevalence of Comorbid Postpartum Depression and Anxiety in Birthing Parents Seeking Treatment for Postpartum Depression: Prévalence de la présence comorbide de la dépression et de l’anxiété post-partum chez les parents ayant accouché qui ont consult

Karley V. George, Calan D. Savoy, Haley Layton, Peter J. Bieling, Ryan J. Van Lieshout
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Objective

To estimate the prevalence of comorbid postpartum depression (PPD) and postpartum anxiety (PPA) in birthing parents seeking treatment for PPD in Ontario, Canada and who were enrolled in 1 of 9 randomized controlled trials (RCTs) of cognitive behavioural therapies (CBT) for PPD.

Methods

Secondary analysis of 9 pooled RCTs containing baseline data from 1920 birthing parents and conducted between 2017 and 2025. All participants were living in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) Scores ≥10 and infants <12 months old. Comorbid anxiety was assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale, the Penn State Worry Questionnaire (PSWQ) and/or the Mini International Neuropsychiatric Interview (MINI).

Results

Sixty-six percent of participants with PPD (EPDS scores ≥10) had moderate to severe anxiety (GAD-7 scale score ≥10; 95% confidence interval (CI) 63–68%, 7 studies, n  = 1654), and 69% with PPD met the cutoff for probable GAD (PSWQ scale score ≥61; 95% CI [63–74%], 2 studies, n  = 254). Seventy percent of participants with MINI-defined current major depressive disorder (MDD) met Diagnostic and Statistical Manual of Mental Disorders—4th Edition -based criteria for any anxiety disorder (95% CI [64–76%], 6 studies, n   =  448). Nearly 60% of participants with current MDD met criteria for GAD on the MINI (95% CI [52–61%], n  = 448).

Conclusions

More than two-thirds of treatment-seeking individuals with PPD have clinically significant anxiety. Those with PPD, their families, and healthcare professionals should be aware of the high prevalence of anxiety in these individuals so that treatment plans can be optimized to best meet their needs.

Trial Registration

ClinicalTrials.gov ( https://clinicaltrials.gov/ ): NCT03039530, NCT03654261, NCT03285139, NCT04485000, NCT04928742, NCT04934488, NCT04913584, NCT05314361 and NCT05044455.

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